We propose to study the effect of alcohol on esophageal motility in a group of alcoholic patients and in an animal model. In individuals exposed chronically to alcohol, esophageal problems such as gastroesophageal reflux, esophagitis, aspiration of regurgitated or swallowed material, dysphagia, and risk of esophageal perforation are common. Underlying alterations of esophageal motility and function are suggested, but to date, investigation has been minimal and has relied on outdated methods. Furthermore, there has been no correlation of observations with esophageal function. We will evaluate patients hospitalized for a four week alcohol problem treatment program. Motility of the esophagus will be assessed manometrically using a low compliance infused catheter system of high recording fidelity permitting records that are accurate and reproducible. We will define the motility disorder shortly after admission in a setting of recent alcohol use and dependence and again following completion of the rehabilitation program. Additionally, gastroesophageal reflux and acid clearing testing will be carried out to assess the major functional implications of these changes. Concurrent with the study in patients, an animal model (opossum) currently in use to study esophageal motility will be adapted to the purpose of the project by utilizing a technique for chronic long-term intravenous infusion. Serial manometric measurements of esophageal motility will be made during chronic intravenous infusion of alcohol and following withdrawal. Some animals will receive nutritional support; others will not. The relative roles played by simple chronic exposure to alcohol, development of alcohol dependency, and nutritional status in development of motor abnormalities will be clarified. Careful observations in a controlled laboratory environment coupled with definition of the problem and its sifnificance in the chronic alcoholic patient is an initial step in the subsequent development of effective clinical approaches to a common problem.